Using VA Benefits to Pay for Long-Term Care

Can military veterans use their Department of Veterans Affairs benefits to help pay for long-term care?

The answer, as with most things governmental, is complicated. But in general, according to the Administration for Community Living, an agency of the U.S. Department of Health and Human Services, the VA pays for long-term care for service-related disabilities and for certain other eligible veterans, as well as other health programs such as nursing home and at-home care for aging veterans who need long-term care.

“If you qualify and are eligible, a certain amount of (long-term care) will be covered by the Veterans Health Administration,” says John Mastronardi, executive director of The Nathaniel Witherell, a short-term rehab and skilled nursing care center in Greenwich, Connecticut. “If you are a veteran, and I can relate this to my dad, you can apply for benefits.”

The VA also pays for veterans who do not have service-related disabilities, but who are unable to pay for the cost of necessary care, the agency says. Copays may apply depending on the veteran’s income level.

The VA also has two programs to help veterans receive at-home care:

— VA Aid and Attendance benefits and Housebound allowance provide cash to eligible veterans with disabilities and their surviving spouses to purchase home and community-based long-term care services, including personal care and caregiver assistance. The cash is a supplement to the eligible veteran’s pension benefits.

— The Veteran Directed Care Program provides veterans with a flexible budget to purchase services, counseling and other support provided by the Aging Network in partnership with the VA.

[See: How Assisted Living Improves Quality of Life.]

VA Coverage for Long-Term Care

According to the VA, long-term care services for sick or disabled veterans include:

— 24/7 nursing and medical care.

— Physical therapy.

— Help with daily tasks, such as bathing, dressing, making meals and taking medicine.

— Comfort care and pain management help.

— Support for caregivers who may need skilled help or a break so they can work, travel or run errands.

Veterans can access this care in several different locations. Some are run by the VA, while others are VA-approved state or community organizations. These settings may include:

— Nursing homes.

Assisted living centers.

— Private homes where a caregiver supports a small group of individuals.

— Adult day health centers.

— Veterans’ own homes.

[Read: What’s the Difference Between Types of Long-Term Care Facilities?]

How to Access LTC Services

The VA says that, to use one or more of these services, veterans must meet all of the requirements below:

— The veteran has signed up for VA health care.

— The VA confirms that the veteran needs a specific service to help with ongoing treatment and personal care.

— The service or space in the care setting is available nearby.

Other factors, such as service-connected disability status or insurance coverage, may also be considered for access to services.

The VA covers some of these services under its standard health benefits under VA health care. A copay may be required for some covered services.

Other services aren’t covered under VA health care benefits, but they may be covered through Medicaid, Medicare or a private insurance policy.

[See: 9 Rewards of Caregiving.]

Eligibility

Eligibility for long-term care services, provided in any long-term care setting, will be determined based on the veteran’s need for ongoing treatment, personal care and assistance, and based on the availability of the service in his or her location, the VA says. Financial status, service-connected (VA disability) status, insurance coverage and/or the ability to pay may also apply, it says.

Once the veteran is enrolled in VA health care, the VA will review his or her service-connected disability status and income to determine if a copay for VA health care services and VA long-term care services will apply. The VA states that long-term care copays are different from standard VA health care copays because they are not charged until the 22nd day of care. Copays are not charged for any hospice care. However, the VA is required by law to bill any health insurance that the veteran may have (except Medicare) for treatment of conditions that are not connected to service. These payments may reduce the VA copays, the VA says.

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Using VA Benefits to Pay for Long-Term Care originally appeared on usnews.com

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